Healthcare Provider Details

I. General information

NPI: 1447812003
Provider Name (Legal Business Name): CLINTON HMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S 30TH ST
CLINTON OK
73601-3657
US

IV. Provider business mailing address

PO BOX 689022
FRANKLIN TN
37068-9022
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-2300
  • Fax: 580-323-8170
Mailing address:
  • Phone: 615-778-8196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES P. WRIGHT
Title or Position: VP PHYSICIAN BUSINESS SERVICES
Credential: AO
Phone: 615-778-1502